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1
Reynolds, Paul N. „The role of tachykinins in airway inflammation and bronchial hyper-responsiveness /“. Title page, contents and abstract only, 1999. http://web4.library.adelaide.edu.au/theses/09PH/09phr464.pdf.
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2
Zhao, Hanjun, und 赵旵军. „A study of antiviral peptides with broad activity against respiratory viruses“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/205838.
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A safe, potent and broad-spectrum antiviral is urgently needed to combat emerging viral respiratory diseases such as avian influenza H5N1 and H7N9, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Previous studies carried out by PhD students in our lab found that mouse β-defenisn 4 (mBD4) shows highly antiviral activity in vitro. However, the recombinant mBD4 (rmBD4) expressed by E.coli is limited to very small scale of production and is very expensive.
Thus, in this study, we firstly screened 16 short peptides derived from mBD4 and other mouse and human β-defensins for identifying their antiviral effects. One short peptide P9 (30 amino acids), derived from mBD4, exhibited potent and broad-spectrum antiviral effects against multiple respiratory viruses, including influenza A viruses H1N1, H3N2, H5N1, H7N7 and H7N9, SARS coronavirus (SARS-CoV)and MERS coronavirus (MERS-CoV). This P9 showed very high selectivity index (970), which was higher than that of the full-length peptide of synthetic mBD4 (smBD4) and rmBD4 in vitro. Secondly, the prophylactic and therapeutic effects of P9 against the infection of H1N1 virus were further detected in animal model. The survival rate of P9-pretreated mice challenged by lethal dose of H1N1 virus was 100%. The therapeutic effects of P9 protecting mice from lethal challenge of H1N1 virus were also statistically significant. The survival rate of mice could reach up to 67% by intranasal inoculation and 56% by intraperitoneal injection, respectively.
To investigate the antiviral mechanism, we firstly elucidated that P9 could inhibit viral infection but not viral replication or release. Secondly, we detected whether P9 inhibited viral infection by binding to the surface of target cells or viral particles. The results showed that P9 only bound to viral particles but not to the cell surface. It was further identified that P9 bound to viral surface glycoprotein HA but not NA. Thirdly, we demonstrated that P9 did not inhibit virus binding to its receptor and block the virus entry into cells by endocytosis. Instead, P9 inhibited the acidification in late endosomes and thusP9 blocked virus-membrane fusion and subsequent viral disassembly and viral RNA release. Finally, we elucidated that the antiviral activity of P9 was attributed to its high binding affinity to viral HA and the abundance of basic amino acids in its composition.
In this study, we have demonstrated that a short peptide P9, which is derived from mBD4, showed potent antiviral activity against multiple respiratory viruses. This peptide can be developed to a new promising prophylactic and therapeutic agent with broad-spectrum antiviral activity and low possibility to cause drug resistance. Moreover, this study has also revealed a novel antiviral mechanism for P9 and paved a path for the development of new antiviral agents with broad-spectrum antiviral activity against emerging respiratory viruses, such as avian influenza H5N1 and H7N9, as well as SARS-CoV and MERS-CoV.published_or_final_version
Microbiology
Doctoral
Doctor of Philosophy
3
Yip, Ming-shum, und 葉名琛. „Immune responses of human respiratory epithelial cells to respiratory syncytial virus and human metapneumovirus“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B3955725X.
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4
Chaturvedi, Rakesh K. „Reasoning about therapeutic and patient management plans in respiratory medicine by physicians & medical students“. Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=41562.
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Recently, there has been extensive research in the area of diagnostic expertise. The model of diagnostic reasoning and clinical expertise has been well documented (Patel et al., in press). This study attempts to extend this research in order to include therapeutic reasoning. Using the expert-novice paradigm, this study attempts to investigate the use of knowledge, specifically, both biomedical and clinical sciences, and the directionality of reasoning during decision making about patient management and therapeutic planning in respiratory medicine.Subjects at four levels of expertise were given two clinical problems with the diagnosis and asked (a) to provide therapeutic plans, and (b) describe the underlying pathophysiological explanations of the diseases. Think-aloud protocols were audio-taped and analyzed using methods of protocol analysis. The results showed that the use of basic medical sciences increased as a function of expertise in the procedure-oriented decision-making tasks. The novices generated rule-based prototypical textbook descriptions based on the clinical information, and the diagnosis given in the task. In contrast, the experts' therapeutic responses showed a predominance of causal-level inferences, reflecting more backward-directed inferences than novices. Although both the novices and experts generated forward-directed inferences, the novices were unable to provide accurate and adequate explanations for their decisions. Finally, the pathophysiological explanations of the disease were generated from a different knowledge source than that used to develop therapeutic decisions.
The implications of these findings for development of theory of expertise and for education in the medical domain are discussed.
5
Paudyal, Priyamvada. „Respiratory symptoms and lung function in relation to cotton dust and endotoxin exposure in textile workers in Nepal“. Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=166944.
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Background: Cotton workers are highly exposed to organic dust. Inhalation of cotton based particulate has been associated with various respiratory symptoms and impaired lung function. This study investigates the respiratory health profile of textile mill workers in Nepal in relation to dust and endotoxin exposure. Methods: This study was conducted in four sectors (garment, carpet, weaving and recycling) of the textile industry in Kathmandu, Nepal. A total of 938 individuals completed a health questionnaire and performed spirometry. A subset of 384 workers performed cross-shift spirometry. Personal exposure to inhalable dust and airborne endotoxin was measured during a full-shift for a 114 workers. Results: Geometric mean concentrations of personal exposure to cotton dust and endotoxin were 0.81 mg/m3 and 2160 EU/m3 respectively. Overall prevalence of persistent cough, persistent phlegm, wheeze, breathlessness and chest tightness were 8.5%, 12.5%, 3.2%, 6.5%and 3.6% respectively. Symptoms were most common among the recyclers and less in the garment sector. Exposure to inhalable dust significantly predicted the symptoms of persistent cough and chest tightness. Significant cross-shift reduction in FEV1, FVC, and FEF25_75 were measured in the textile workers (p<0.001 for all); reductions being greater in the recyclers (-143 ml) and smallest in the garment workers (-38 ml) (p=0.012). Cross-shift reduction in FEV1 was significantly predicated by exposure to inhalable dust. Exposure to endotoxin did not correlate with any of the respiratory symptoms nor to lung function. Conclusion: The measured association between exposure to inhalable dust and reporting of respiratory symptoms and lung function suggests that despite high levels of endotoxin exposures, inhalable dust is the driver for these effects and attention should turn to what might be the toxic component in this dust other than endotoxin.
6
Wai, Chi-wan, und 衛至韻. „Development of shell vial culture assay for the rapid diagnosis of respiratory viruses using the human colorectal adenocarcinoma (CaCo2) cells“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193551.
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Background: Respiratory diseases are common worldwide, which are caused by various respiratory viruses. As symptoms caused by these viruses are similar, laboratory diagnosis is essential to distinguish the virus. Conventionally, respiratory viruses are isolated by cell culture with a panel of cell lines. However, handling of several cell lines is labour intensive, and the turnaround time of conventional culture is long. In previous study, the use of human colon adeno-carcinoma (Caco-2) in conventional culture was investigated. The study has proven that Caco-2 is generally susceptible to the eight common respiratory viruses, i.e. Adenovirus, Influenza A and B, Respiratory Syncytial virus, Parainfluenza virus 1, 2,3 and 4. As turnaround time of conventional culture is long; therefore, in this study, rapid shell vial culture using Caco-2 cells were evaluated. Moreover, the application of Caco-2 shell vial culture on recovering human metapneumovirus (hMPV) was also investigated.
Materials and methods: This study consisted of four stages. First, recovery of viruses by conventional culture and shell vial culture of Caco-2 were compared. Specimens were added to conventional culture and shell vial simultaneously. For conventional culture, formation of CPE was examined daily and IF staining was performed when CPE was indicated; meanwhile, shell vial culture were incubated for seven days and stained with IF to detect infected cells. In stage two, the effect of incubating shell vial culture in rolling drum was investigated. Shell vials inoculated with the same specimen in duplicate were incubated in rolling drum and without rolling drum simultaneously. IF staining was performed in day 2, and results were obtained. For those which are IF negative in day 2, second shell vial was further incubated to seven days before harvest. In the next stage, a large batch of samples was used to evaluate on the use of Caco-2 shell vial culture in day 2 and day 7. Lastly, Caco-2 shell vial and conventional culture and LLC-MK2 conventional culture were tested for isolation of hMPV.
Results: Compared to Caco-2 conventional culture, recovery rate of shell vial culture was elevated slightly. When experimenting on the effect of incubation in rolling drum, results showed that recovery rate was raised in shell vial with rolling drum in day 2, moreover, the percentage of positive cells were increased significantly (p value < 0.05). Furthermore, in the evaluation of Caco-2 shell vial in day 2 and day 7, 75% of samples were isolated in day 2 while 85% were recovered in day 7. Lastly, in the investigation on recovery of hMPV, 53%, 42% and 17% hMPV positive cases were isolated by Caco-2 shell vial, Caco-2 conventional culture and LLC-MK2 conventional culture respectively.
Conclusion: First, although recovery rate by shell vial and conventional culture were similar, turnaround time was reduced from a week to a few days by shell vial culture. Therefore, Caco-2 shell vial culture is a more efficient than Caco-2 conventional culture in isolating respiratory viruses. The study also showed that incubation of shell vial in rolling drum able to increase the number of positive cells. Furthermore, in this study, Caco-2 cells were also shown to be more efficient in isolating hMPV when compare to LLC-MK2 cells.published_or_final_version
Microbiology
Master
Master of Medical Sciences
7
岑海音 und Hoi-yum Irma Shum. „Interactions of pseudomonas aeruginosa toxins with respiratory mucosa in vitro“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31244725.
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8
Soh, Kim Lam. „Knowledge about nosocomial pneumonia prevention among critical care nurses in New Zealand a thesis presented in partial fulfillment of the requirement for the degree of Master of Health Science, Auckland University of Technology, September 2003 /“. Full thesis. Abstract, 2003. http://puka2.aut.ac.nz/ait/theses/SohK.pdf.
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Thesis (MHSc--Health Science) -- Auckland University of Technology, 2003.Appendix B not included in e-thesis. Also held in print (128 leaves, 30 cm.) in Akoranga Theses Collection. (T 610.7361 SOH)
9
胡慧明 und Huie-ming Hou. „Long-term study of sleep apnoea patients treated with MAD“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45012222.
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10
Lee, Kathleen F. „Clinical competencies required for graduates of an entry-level associate degree respiratory care program to practice competently“. Virtual Press, 2002. http://liblink.bsu.edu/uhtbin/catkey/1247887.
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The purpose of this study was to identify the complete scope, cognitive, affective and psychomotor, of clinical competencies required for the successful practice by entry-level associate degree respiratory care graduates entering the workforce. The study was conducted using a Delphi technique. American Association for Respiratory Care House of Delegates nominated a panel of experts to participate in the study. A total of 55 individuals were nominated and 21 agree to participate in the study. The individuals represented both college-based educators and hospital managers and educators. The initial questionnaire requested that each panel member list those cognitive, affective and psychomotor clinical competencies that they believed to be required for successful entrylevel practice. The responses from the first round were grouped into like categories and returned to the panel members to be rated on a four-point scale during the second and third rounds of the study. Consensus was achieved with the third round resulting in a final list of 26 cognitive, 20 affective and 28 psychomotor clinical competencies. The final list of competencies includes the most basic cognitive and psychomotor skills of the profession and did not include many of the areas listed by the National Board for Respiratory Care exam matrix. The study also lists 20 affective attributes as essential for successful practice. There are no current standardized methods in use to evaluate affective skills. Research will need to continue to clarify the skills needed for competent and successful entry-level practice.Department of Educational Studies
11
Ratnawati, Ratnawati Prince of Wale Hospital Clinical School UNSW. „Exhaled nitric oxide in asthmatic airway inflammation“. Awarded by:University of New South Wales. Prince of Wale Hospital Clinical School, 2006. http://handle.unsw.edu.au/1959.4/25729.
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Measuring the level of exhaled NO (eNO) in the breath is a new method to monitor airway inflammation in asthma and may have a role in the management of asthma. The hypotheses were that eNO will reflect the degree of inflammation in chronic asthma, and will indicate how anti- inflammatory therapy should be altered to improve asthma control. Three studies were performed to test the hypotheses. A cross sectional study was performed to define the normal range of eNO and to compare this range with those who have asthma or atopy. The second study was observational, to compare the level of eNO during and after an exacerbation of asthma. The third study was an interventional study to evaluate eNO in management of paediatric asthma. In this latter study the level of eNO was measured to monitor airway inflammation in asthmatic children with the intention of adjusting antiinflammatory drugs (inhaled glucocorticosteroids) according to the level of eNO. These studies have shown that the mean level of eNO was significantly higher in asthmatic compared with normal subjects, but not significantly different when compared with atopic non-asthmatic subjects. eNO was correlated with the number of positive skin prick tests in atopic subjects whether asthmatic or nonasthmatic. The eNO level was increased during acute exacerbations of asthma and decreased after two weeks with therapy of GCS. In a pilot study eNO appeared to be superior to FEV1 in adjusting the dose of iGCS to control asthmatic children, but this needs to be confirmed with a larger sample size. Another non-invasive method to detect inflammatory markers is the technique of exhaled breath condensate (EBC). Although NO is degraded to NOx, it was found that eNO had no significant correlation with EBC NOx but had a significant correlation with pH. Hypertonic saline challenge, an artificial model of an asthmatic exacerbation was associated with an increase in EBC volume and the release of histamine, implicating mast cell activation. These novel findings suggest that non-invasive markers can be used both for clinical and mechanistic proposes.
12
Faganello, Marcia Maria. „Fatores associados à ocorrência de exacerbação em pacientes com DPOC /“. Botucatu : [s.n.], 2007. http://hdl.handle.net/11449/102611.
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Orientador: Irma de GodoyBanca: Hugo Hyung Bok Yoo
Banca: Fabio de Oliveira Pitta
Banca: Maria Christina L. O. Machado
Banca: Alberto Cukier
Resumo: Nos últimos anos, vários estudos avaliaram os marcadores da doença associados à freqüência de exacerbação, hospitalização, readmissão e mortalidade em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC). Entretanto, estudos que avaliaram os marcadores associados à ocorrência de exacerbação em pacientes ambulatoriais são limitados. Assim, o objetivo deste estudo foi identificar os fatores de predição da ocorrência de exacerbação no período de um ano em 120 pacientes com DPOC atendidos no Ambulatório de Pneumologia da Faculdade de Medicina de Botucatu - Unesp. Os pacientes tiveram o diagnóstico de DPOC confirmado e foram submetidos às seguintes avaliações: espirometria pré e pós-broncodilatador, composição do corpo (antropometria e bioimpedância), qualidade de vida por meio do Saint Georges Respiratory Questionnaire (SGRQ), intensidade da dispnéia por meio da escala modificada Medical Research Council (MMRC) e do índice basal de dispnéia (BDI) e tolerância ao exercício (distância percorrida em 6 minutos DP6). Em seguida foi calculado o índice BODE de acordo com os pontos de corte do volume expiratório no primeiro segundo (VEF1), do índice de massa do corpo, do MMRC e da DP6. Durante o período de acompanhamento de um ano, 60 pacientes (50%) apresentaram pelo menos um episódio de exacerbação da doença e, em conseqüência da agudização, 25 pacientes foram hospitalizados. Comorbidades extra-pulmonares foram causa de hospitalização em oito pacientes e de óbito em cinco pacientes. Na avaliação inicial, os pacientes que exacerbaram tinham maior comprometimento da função pulmonar e da troca gasosa, valores mais elevados do índice BODE e maior proporção de pacientes com DPOC III e IV. Além disso, apresentavam menores valores de DP6, maior sensação de dispnéi... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Markers of disease severity have been associated with mortality, occurrence and frequency of hospitalization and readmission due disease exacerbation in chronic obstructive pulmonary disease (COPD) patients. However, information about predictor factors for the occurrence of exacerbation in ambulatory COPD patients is scarce. Therefore, the aim of the present study was to identify predictor factors for the occurrence of exacerbation in 120 patients with COPD followed during one year in the outpatient clinic at Universidade Estadual Paulista (UNESP, Paulista State University) School of Medicine at Botucatu, located in the State of São Paulo, Brazil. The patients had the diagnosis of COPD confirmed and underwent to the following evaluations: pre- and postbronchodilator spirometry, body composition (anthropometry and bioimpedance), health-related quality of life (Saint Georges Respiratory Questionnaire -SGRQ), dyspnea scores (Medical Research Council MMRC and basal dispnea index -BDI) and exercise tolerance (6MWD). Bode index was calculated taking in consideration the cutt off points for forced volume in the first second (FEV1), body mass index, MMRC and 6MWD. During the followup period 60 patients (50%) presented at least one exacerbation episode and, as consequence, 25 patients were hospitalized. Eight patients were hospitalized and five died due to non-pulmonary comorbidities. At baseline, patients with exacerbations during the follow-up period presented lower values of airway obstruction indexes and of arterial blood gases and higher values of BODE score and proportion of COPD patients class III and IV. In addition, the values of 6MWD were lower, dyspnea sensation was higher and the health- related quality of life was more deteriorated in these patients. No significative associations were found between gender, corticosteroid use... (Complete abstract click electronic access below)
Doutor
13
Hinze, Candace. „The role of malnutrition in prolonged respiratory failure : the effect of accelerated nutritional rehabilitation“. Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22740.
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To investigate the possibility that malnutrition is an important factor that prolongs respiratory failure (PRF), I studied the effects of pharmacologic injections of recombinant human growth hormone (rhGH), an important anabolic stimulus, on nutritional and respiratory parameters in patients requiring mechanical ventilation for more than three days. Patients were excluded from consideration if dominating factors known to prolong ventilatory failure had not been stabilized. Over ten months, 106 patients in PRF were evaluated, but only six met the selection criteria. Three patients were randomized to receive standard nutritional support, and three into a group that received the equivalent nutrition plus 5 mg/day of rhGH for 14 days or until withdrawal of mechanical ventilation. Baseline characteristics of the selected patients were divergent as demonstrated by body mass indexes ranging from 14 to 42 (kg/m$ sp2),$ baseline maximal inspiratory pressures (PI$ sb{ max}$ from $-$15 to $-$70 cm H$ sb2$O, and Day 1 N balances from $-$13.5 to 1.2 g N/day. Despite increased plasma insulin-like growth factor-1 concentrations, the mean daily N balances of the rhGH-treated group were no better than the controls (1.3 $ pm$ 5.0 vs. 0.4 $ pm$ 2.6 g N/day; Mean $ pm$ SD), nor were there differences in PI$ sb{ max},$ level of ventilatory assistance required, and days to weaning. The persistence of respiratory failure in the overwhelming majority of patients in PRF appears to be due to factors already known to prevent weaning from mechanical ventilation. Even the carefully selected patients enrolled in the present study were insufficiently homogeneous or stable enough to allow proper testing of the experimental hypothesis.
14
Wang, Liping. „An investigation of the association between herpesviruses and respiratory disease in racehorses in Western Australia“. Thesis, Wang, Liping (2003) An investigation of the association between herpesviruses and respiratory disease in racehorses in Western Australia. PhD thesis, Murdoch University, 2003. https://researchrepository.murdoch.edu.au/id/eprint/386/.
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Respiratory disease is an important cause of wastage in the Australian horse racing industry and viruses are frequently suspected as aetiological agents of respiratory disease or poor performance by clinicians and trainers but confirmation is seldom attempted. This thesis deals with the potential role of equine herpes virus types 1, 2, 4 and 5 in upper respiratory disease and poor performance in horses in Western Australia.
The methodology selected for the identification of equine herpes viruses in tissues of horses was polymerase chain reaction (PCR) and therefore individual PCR assays were developed for the detection of each herpes virus, and then a nested multiplex PCR was developed to detect all four viruses. There was good correlation between the multiplex PCR for the detection of EHV and the detection of virus by isolation in cell culture, although a combination of the 2 techniques provided greater sensitivity than either technique alone. The multiplex PCR described appeared equally sensitive as specific PCR assays using a single set of primers for each individual virus but reduced labour and reagent costs.
As latency is a well recognised phenomenon in the equine herpes viruses and the horse is subjected to a number of stresses which might induce reactivation of latent infections, it was hypothesised that there would be a background level of replication of the equine herpes viruses in clinically normal horses. Nasal swabs and peripheral blood leukocytes (PBL) were obtained from 282 clinical normal horses and examined for EHV. The results clearly demonstrated the widespread occurrence of EHV in the clinically healthy horses. The rate of detection of different types of EHV varied, as did the prevalence in young and adult horses. The most common EHV detected was EHV5: in 83.2% of 131 of horses <2 years of age; in 40% of horses >2 years of age.
A prospective clinical study was conducted whereby respiratory tract samples and PBL from adult horses with respiratory disease and/or poor performance were examined for equine herpes viruses; the aim was to determine a possible association between equine herpes virus infection and respiratory disease and/or poor performance. The relative incidence of factors identified in the history, signalment, physical and laboratory evaluation of horses in the study population was compared between horses from which EHV was identified in respiratory samples and horses negative for equine herpes virus. The results indicated that equine herpes viruses were important causes of respiratory disease in the study population, and that haematological and cytological data were a poor indicator of such equine herpes virus infection.
The occurrence of equine herpes virus in nasal swabs and PBL of weaned or unweaned foals from Thoroughbred breeding establishments was determined and provided data on the occurrence of EHV in association with respiratory disease. EHV5 was detected in nasal swabs and/or PBL at a high prevalence rate in healthy foals and yearling horses but its occurrence was not associated with clinical signs of respiratory disease. In contrast, EHV2 was detected more commonly in nasal swabs and/or PBL from foals with respiratory disease than in similar samples from healthy horses. Experimental infection of 8 horses with EHV2 was attempted and induced clinical signs of respiratory disease, but less severe than observed in the epidemiological studies. The results suggested that EHV2 is associated with mild upper respiratory tract infection in young horses.
15
Wang, Liping. „An investigation of the association between herpesviruses and respiratory disease in racehorses in Western Australia“. Wang, Liping (2003) An investigation of the association between herpesviruses and respiratory disease in racehorses in Western Australia. PhD thesis, Murdoch University, 2003. http://researchrepository.murdoch.edu.au/386/.
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Respiratory disease is an important cause of wastage in the Australian horse racing industry and viruses are frequently suspected as aetiological agents of respiratory disease or poor performance by clinicians and trainers but confirmation is seldom attempted. This thesis deals with the potential role of equine herpes virus types 1, 2, 4 and 5 in upper respiratory disease and poor performance in horses in Western Australia.
The methodology selected for the identification of equine herpes viruses in tissues of horses was polymerase chain reaction (PCR) and therefore individual PCR assays were developed for the detection of each herpes virus, and then a nested multiplex PCR was developed to detect all four viruses. There was good correlation between the multiplex PCR for the detection of EHV and the detection of virus by isolation in cell culture, although a combination of the 2 techniques provided greater sensitivity than either technique alone. The multiplex PCR described appeared equally sensitive as specific PCR assays using a single set of primers for each individual virus but reduced labour and reagent costs.
As latency is a well recognised phenomenon in the equine herpes viruses and the horse is subjected to a number of stresses which might induce reactivation of latent infections, it was hypothesised that there would be a background level of replication of the equine herpes viruses in clinically normal horses. Nasal swabs and peripheral blood leukocytes (PBL) were obtained from 282 clinical normal horses and examined for EHV. The results clearly demonstrated the widespread occurrence of EHV in the clinically healthy horses. The rate of detection of different types of EHV varied, as did the prevalence in young and adult horses. The most common EHV detected was EHV5: in 83.2% of 131 of horses <2 years of age; in 40% of horses >2 years of age.
A prospective clinical study was conducted whereby respiratory tract samples and PBL from adult horses with respiratory disease and/or poor performance were examined for equine herpes viruses; the aim was to determine a possible association between equine herpes virus infection and respiratory disease and/or poor performance. The relative incidence of factors identified in the history, signalment, physical and laboratory evaluation of horses in the study population was compared between horses from which EHV was identified in respiratory samples and horses negative for equine herpes virus. The results indicated that equine herpes viruses were important causes of respiratory disease in the study population, and that haematological and cytological data were a poor indicator of such equine herpes virus infection.
The occurrence of equine herpes virus in nasal swabs and PBL of weaned or unweaned foals from Thoroughbred breeding establishments was determined and provided data on the occurrence of EHV in association with respiratory disease. EHV5 was detected in nasal swabs and/or PBL at a high prevalence rate in healthy foals and yearling horses but its occurrence was not associated with clinical signs of respiratory disease. In contrast, EHV2 was detected more commonly in nasal swabs and/or PBL from foals with respiratory disease than in similar samples from healthy horses. Experimental infection of 8 horses with EHV2 was attempted and induced clinical signs of respiratory disease, but less severe than observed in the epidemiological studies. The results suggested that EHV2 is associated with mild upper respiratory tract infection in young horses.
16
Anua, Siti Marwanis. „Workplace and home exposure to respiratory sensitisers : examining the work to home pathway“. Thesis, University of Aberdeen, 2012. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=203876.
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Background: Contamination of the skin and clothing may lead to workers inadvertently bringing harmful materials home and exposing family members, so called para-occupational exposure. This study investigates whether workplace contamination with respiratory sensitisers such as laboratory animal allergens, flour, isocyanates and enzymes is transported from work to the home environment. Methods: 3 laboratory animal facilities, 92 bakeries, 47 car body workshops, and 2 hospitals in the Grampian region of Scotland were invited to take part in a series of linked studies to increase understanding of the ‘take-home' pathway. Control subjects were recruited from staff and students at the University of Aberdeen. Take-home exposure assessment was carried out using two techniques: surface wipe sampling and vacuum sampling in workplaces, cars and homes. Samples were also collected in the homes of control subjects. Samples from bakers were analysed for total protein, wheat flour antigen (WFA) and fungal alpha amylase (FAA) while samples from laboratory animal workers were analysed for mouse urinary protein (Mus m 1). Enzyme cleaning agents were analysed for subtilisin proteolytic activity. Similar methods using SWYPE™ aliphatic pads for isocyanate contamination assessment were conducted among car body repairers. The pads were scanned and images of SWYPE™ pads were used to estimate contamination against the quantitative assay MDHS 25/3. All analyses were done by the Health and Safety Laboratory (HSL) apart from the SWYPE™ RGB tests and gravimetric measurements. Results: A total of 13 laboratory animal workers in 3 animal facilities, 38 bakers in 5 bakeries, 13 car painters in 5 car body workshops and 20 control subjects participated in the study. Two hospitals were surveyed for enzyme exposures and 3 endoscope cleaning technicians were monitored. Evidence of take-home exposure was found for bakery workers, with potential contamination that could lead to home exposure in the car body repair and hospital workers. Higher levels of Mus m 1 contamination were detected on house door handles of non-exposed controls compared to the exposed laboratory workers (0.62 vs. 0.1 ng/wipe, p<0.001) probably due to exposure variability, might be because exposed laboratory workers being involved in a job that requires more hand washing than the general population, or suggesting widespread environmental contamination with this allergen, and these making it impossible to determine if work-home pathway exists for these workers. There was detectable WFA and FAA found on the hands, forehead, shoes, cars and homes of bakers. Compared to controls, bakers had higher median levels of WFA and FAA in house vacuum samples; the difference was statistically significant for WFA/total protein (516x10-6 vs. 164x10-6, p=0.031), FAA/total protein ratios (1.45x10-6 vs. 0.04x10-6, p<0.001) and FAA loading (1.2 pg/cm2 vs. 0.1 pg/cm2, p<0.001). Among car painters, SWYPE™ colorimetric colour changes score showed three positive SWYPE™ colour changes on skin, and three positive results on shoes of car body workshop workers. However quantitative colour analysis of the SWYPE™ pads proved ineffective for field measurements. Hand wipes of hospital workers during mid-shift and post-shift showed evidence of proteolytic activity, indicating possible spread of contamination from hands, unsatisfactory hygiene practices and the potential for take-home contamination of enzyme. Presence of contamination on footwear indicated that possible transfer of enzyme to other places including homes may occur. Conclusion: These data demonstrate the existence of pathways for take-home exposure of allergens among bakers via skin and clothing from workplaces to cars and workers' homes. The take-home pathway for laboratory animal allergens and isocyanates was not demonstrated and further investigation should be performed for enzyme cleaning agents used in healthcare settings by monitoring dermal take-home exposure with comparison to controls. Further work is needed to ascertain how widespread the take-home of respiratory sensitisers may be and the possible implications to the health of workers' families and the wider community. If parental occupation can lead to take-home exposure to respiratory asthmagens, and consequently to childhood asthma, then this represents a potentially modifiable risk factor for these cases of para-occupational asthma. There is a need for greater understanding of the take-home pathway of exposure to asthmagens and sensitisers and for a programme of education and control measures to limit the transfer of such material from the workplace to the home and wider community.
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Yu, Peng, und 于朋. „Air pollution and respiratory disease incidence of Guangzhou: a study of spatial interpolation methodsusing GIS, 2003-2004“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41633799.
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Lau, Siu-pik. „Time-series analysis of the relationship between influenza-like illness and mortality due to respiratory and cardiovascular diseases in Hong Kong“. Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/b39724165.
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Faganello, Marcia Maria [UNESP]. „Fatores associados à ocorrência de exacerbação em pacientes com DPOC“. Universidade Estadual Paulista (UNESP), 2007. http://hdl.handle.net/11449/102611.
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Nos últimos anos, vários estudos avaliaram os marcadores da doença associados à freqüência de exacerbação, hospitalização, readmissão e mortalidade em pacientes portadores de doença pulmonar obstrutiva crônica (DPOC). Entretanto, estudos que avaliaram os marcadores associados à ocorrência de exacerbação em pacientes ambulatoriais são limitados. Assim, o objetivo deste estudo foi identificar os fatores de predição da ocorrência de exacerbação no período de um ano em 120 pacientes com DPOC atendidos no Ambulatório de Pneumologia da Faculdade de Medicina de Botucatu - Unesp. Os pacientes tiveram o diagnóstico de DPOC confirmado e foram submetidos às seguintes avaliações: espirometria pré e pós-broncodilatador, composição do corpo (antropometria e bioimpedância), qualidade de vida por meio do Saint George s Respiratory Questionnaire (SGRQ), intensidade da dispnéia por meio da escala modificada Medical Research Council (MMRC) e do índice basal de dispnéia (BDI) e tolerância ao exercício (distância percorrida em 6 minutos DP6). Em seguida foi calculado o índice BODE de acordo com os pontos de corte do volume expiratório no primeiro segundo (VEF1), do índice de massa do corpo, do MMRC e da DP6. Durante o período de acompanhamento de um ano, 60 pacientes (50%) apresentaram pelo menos um episódio de exacerbação da doença e, em conseqüência da agudização, 25 pacientes foram hospitalizados. Comorbidades extra-pulmonares foram causa de hospitalização em oito pacientes e de óbito em cinco pacientes. Na avaliação inicial, os pacientes que exacerbaram tinham maior comprometimento da função pulmonar e da troca gasosa, valores mais elevados do índice BODE e maior proporção de pacientes com DPOC III e IV. Além disso, apresentavam menores valores de DP6, maior sensação de dispnéi...
Markers of disease severity have been associated with mortality, occurrence and frequency of hospitalization and readmission due disease exacerbation in chronic obstructive pulmonary disease (COPD) patients. However, information about predictor factors for the occurrence of exacerbation in ambulatory COPD patients is scarce. Therefore, the aim of the present study was to identify predictor factors for the occurrence of exacerbation in 120 patients with COPD followed during one year in the outpatient clinic at Universidade Estadual Paulista (UNESP, Paulista State University) School of Medicine at Botucatu, located in the State of São Paulo, Brazil. The patients had the diagnosis of COPD confirmed and underwent to the following evaluations: pre- and postbronchodilator spirometry, body composition (anthropometry and bioimpedance), health-related quality of life (Saint George s Respiratory Questionnaire -SGRQ), dyspnea scores (Medical Research Council MMRC and basal dispnea index -BDI) and exercise tolerance (6MWD). Bode index was calculated taking in consideration the cutt off points for forced volume in the first second (FEV1), body mass index, MMRC and 6MWD. During the followup period 60 patients (50%) presented at least one exacerbation episode and, as consequence, 25 patients were hospitalized. Eight patients were hospitalized and five died due to non-pulmonary comorbidities. At baseline, patients with exacerbations during the follow-up period presented lower values of airway obstruction indexes and of arterial blood gases and higher values of BODE score and proportion of COPD patients class III and IV. In addition, the values of 6MWD were lower, dyspnea sensation was higher and the health- related quality of life was more deteriorated in these patients. No significative associations were found between gender, corticosteroid use... (Complete abstract click electronic access below)
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Medford, Marsha Kay. „Respiratory health hazards of artists in their studios“. Thesis, The University of Arizona, 1989. http://hdl.handle.net/10150/277152.
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Artists are exposed to numerous respiratory health hazards in the production of art. Little is known of artists' studio behaviors or of their health beliefs related to respiratory toxins. The Health Belief Model hypothesizes that individuals require a minimal level of relevant health motivation and knowledge before attempting to prevent a health condition, as well as a perception of their vulnerability to health conditions they view as threatening, conviction in the efficacy of preventive behaviors, and a perception that recommended preventive action entails few difficulties. This descriptive and exploratory study, conducted within the framework of the Health Belief Model, seeks to determine artists' knowledge, health beliefs, and preventive studio practices related to occupational respiratory health risks.
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Lam, Sau-kei Angel, und 林秀琪. „Systematic review on the adverse effects of traffic related air pollution on respiratory health in children“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193836.
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Objectives :
To investigate the impacts of traffic related air pollution (TRAP) on children’s respiratory health, and to investigate the policies and regulations implemented in other countries and the suggestions from the World Health Organization (WHO) to tackle this problem.
Methods and Results:
Using relevant keywords, 122 articles were acquired from PubMed and 15 were from MEDLINE via EBSCO host respectively. The articles were published between 1980 to 2013; all of which had examined the impacts of TRAP on children’s respiratory health. After assessing inclusion and exclusion criteria, 9 articles were finally included in this systematic review. Differences in demographic characteristics were studied and compared to determine the association between TRAP exposure and respiratory health impacts on children aged between 1 and 18. Four cross-section surveys and five cohort studies were selected in this review. The association between TRAP exposure and differences in children’s respiratory impacts were demonstrated in all studies. Multiple outcome measures were used to examine changes of children’s respiratory health such as the decline in lung function, incidences of asthma and inflammatory responses. There were 4 out of 9 articles suggesting the decline in lung function was related to TRAP exposure; 5 out of 9 articles showed the relationships between incidences of asthma and inflammatory responses and TRAP exposure and 2 articles mentioned other respiratory symptoms; notably, wheezing and sneezing, runny and stuffed nose. This review finally summarized the results of selected articles stressing that children who lived close to roadway within a 500 meter radius from home, with an early exposure to air pollution in the first year of age and a frequent exposure to heavy road traffic and outdoor air pollutants would experience greater impacts on respiratory health.
Conclusion:
The positive association between the impacts on children’s respiratory health and TRAP exposure has been determined through this systematic review. Stricter emission control strategies and updated guidelines are required to regulate traffic emission and improve air quality in order to reduce harm and provide a better living environment for our next generations.published_or_final_version
Public Health
Master
Master of Public Health
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Chan, Wan-yi, und 陳韻怡. „Influenza A virus infection of human respiratory epithelium: tissue tropism and innate immuneresponses“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B41633696.
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Vermeulen, Magdalena. „Die invloed van die allergiese reaksie op die respiratoriese sisteem, met spesifieke verwysing na die rol van die rondewurm, Ascaris lumbricoides“. Thesis, Stellenbosch : Stellenbosch University, 1995. http://hdl.handle.net/10019.1/58662.
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Thesis (MSc) -- Stellenbosch University, 1995.ENGLISH ABSTRACT: The aim of this study was to investigate the influence of the allergic reaction on the respiratory system. The influence of parasite infestation (with specific reference to the roundworm, Ascaris lumbricoides) on the normal functioning of the respiratory system was also investigated. Firstly a pilot study was done to determine the normal immunoglobulin E (IgE) levels of coloured newborns in the Western Cape. The cord blood IgE values of a group of coloured newborns were determined by using the RIA technique. Although a mean value was reached, it is important for more controlled studies, that would take into account a variety of factors, to be done before determining separate reference values for this population. The levels of one of the most important effector cells in the allergic reaction, namely eosinphils, were determined in a group of asthma patients by using the counting chamber method. In all the cases the eosinophil levels were elevated The influence of Ascaris lumbricoides on the respiratory system was investigated from two different points of view, namely the possible allergic reactions it could induce in the host and secondly by determing the influence of this parasite on one of the parametres of the respiratory system, namely the peak expiratory flow (PEF) values. In the first case the presence of specific Ascaris allergens in a group of asthma patients was determined by using the RAST technique. The incidence of these specific allergens was however not high. Secondly the PEF values of two groups (the one group was infested with the roundworm and the other not) were compared. Wet stool mounts were investigated under a light microscope to identy parasite ova. There was however no significant difference in PEF values between these two groups. This study underlines the complex interaction between parasites and the respiratory system. Further studies in this regard are needed in order to fully understand the nature of this interaction.
AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om ondersoek in te stel na die invloed wat die allergiese reaksie uitoefen op die respiratoriese sisteem. Daar is verder ook aandag gegee aan die uitwerking van parasiet infestasies (met spesifieke verwysing na die rondewurm, Ascaris lumbricoides) op die normale funksionering van die respiratoriese sisteem. 'n Loodsstudie is eerstens uitgevoer ten einde normale immunoglobulien E (IgE) vlakke vir Kleurling pasgeborenes te bepaal. lgE bepalings is gedoen op die nawelstring bloed van 'n groep Kleurling babas in die Wes-Kaap. Die RIA tegniek is vir hierdie doel gebruik. Hoewel 'n gemiddelde waarde verkry is, is dit egter noodsaaklik dat meer gekontrolleerde studies wat 'n wye verskeidenheid van faktore in ag neem, uitgevoer sal moet word alvorens aparte verwysingswaardes vir hierdie bevolkingsgroep saamgestel kan word. Die voorkoms van een van die belangrikste effektor selle in die allergiese reaksie, naamlik eosinofiele, is bepaal in die bloed van 'n groep asma pasiente. Die eosinofiele is getel deur gebruik te maak van die telkamer metode. In al die gevalle was die eosinofiel vlakke verhoog. Die invloed van Ascaris lumbricoides op die respiratoriese sisteem is vanuit twee oogpunte ondersoek, naamlik die uitlokking van 'n allergiese respons in ~ie gasheer en die invloed van hierdie parasiet op een van die parameters van longfunksie, naamlik "peak expiratory flow" (PEF) vlakke. In die eerste geval is die mate van teenwoordigheid van Ascaris allergene in 'n groep asma pasiente bepaal deur gebruik te maak van die RAST tegniek. Die insidensie van allergie teen hierdie allergene was egter nie hoog nie. Tweedens is die PEF waardes van twee groepe proefpersone (die een groep gei:nfesteer met Ascaris lumbricoides en die ander groep nie) met mekaar vergelyk. Daar was egter nie 'n beduidende verskil tussen die waardes van die twee groepe nie. Parasiet ova is gei:dentifiseer deur die maak van eenvoudige nat stoelgang smere en die ondersoek daarvan onder 'n ligmiroskoop. In hierdie studie word die komplekse aard van die interaksie tussen parasiete en die respiratoriese sisteem duidelik na vore gebring. Verdere studies is nodig ten einde die verband tussen hierdie twee faktore te bepaal.
SNO and Stellenbosch 2000 scholarship
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Lau, Siu-pik, und 劉少碧. „Time-series analysis of the relationship between influenza-like illness and mortality due to respiratory and cardiovascular diseases in Hong Kong“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hdl.handle.net/10722/210302.
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So, Fun-mun, und 蘇歡滿. „An application of geographic information systems in the study of spatial epidemiology of respiratory diseases in Hong Kong, 1996-2000“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B3122782X.
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Yuen, Kit-man, und 阮潔雯. „Comparison of influenza A virus induced apoptosis in human respiratoryepithelial cells: an in vitro and ex vivostudy“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47177019.
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Highly pathogenic avian influenza H5N1, which is panzootic in poultry, continues to spread and becomes endemic in Asia, Africa, and Europe. It causes human disease with high fatality (about 60%) and continues to pose a pandemic threat. The pathological lesions associated with human H5N1 disease is Acute Respiratory Distress Syndrome (ARDS). The biological basis underlying the development of ARDS in human H5N1 disease remains controversial. Clinical, animal and in vitro studies suggested that the differences between H5N1 influenza viruss and low pathogenic influenza viruses in regard to viral replication, tissue tropism and cytokine dysregulation may contribute to disease pathogenesis.
We previously found delayed onset of apoptosis in influenza H5N1 virus infected human peripheral blood monocyte-derived macrophages. This may allow a longer survival time for the virus in target cells for prolonged viral replication, which may contribute to the pathogenesis of H5N1 disease. As human bronchial and alveolar epithelial cells are target cells of influenza virus, I explored if influenza H5N1 and H1N1 virus infected human respiratory epithelial cells displayed differential apoptotic response and dissected the apoptotic pathways triggered by influenza virus infection.
In this study, the apoptotic response in highly pathogenic influenza H5N1 viruses, A/HK/483/97 and A/Vietnam/1203/04, their precursor avian influenza H9N2 virus, A/Quail/HK/G1/97, and seasonal H1N1 virus, A/HK/54/98 infected primary human alveolar and bronchial epithelial cells was compared by TUNEL. A delayed onset of apoptosis in influenza H5N1 viruses and avian H9N2 virus infected alveolar epithelial cells was observed; the pattern was similar in bronchial epithelial cells. Concomitantly, by Western blotting, a delay in caspase 3 activation in H5N1 virus (A/HK/483/97) infected alveolar epithelial cells compared to H1N1 virus (A/HK/54/98) infected cells was shown. Also, influenza H5N1 and H1N1 virus induced apoptosis through both intrinsic and extrinsic pathways in human alveolar epithelial cells. Chemokine IP-10 was differentially up-regulated in influenza H5N1 virus infected alveolar epithelial cells, but its relationship to the delayed onset of apoptosis requires further studies.
TRAIL, an upstream signaling molecule of extrinsic apoptotic pathway, mRNA was up-regulated in influenza H5N1 infected alveolar epithelial cells but not in influenza H1N1 infected cells. Using recombinant viruses, I showed that the 627 amino acid residue on PB2 of H5N1 virus and mutation of amino acids on 253 and 591 residues on PB2 of H9N2 virus contribute to the TRAIL upregulation. Immunohistochemical staining of physiologically relevant ex vivo model of human bronchus showed that influenza H5N1 (A/Vietnam/3046/04) and H9N2 (A/Quail/HK/G1/97) virus did not infect human bronchi as well as human H1N1 (A/HK/54/98) virus. Profiling of apoptosis related genes showed that TRAIL tends to be up-regulated in H5N1 virus infected bronchi ex vivo.
This study demonstrated the delayed onset of apoptosis by H5N1 virus infected respiratory epithelial cells may be a mean for influenza virus to have prolonged replication within the human respiratory tract and contribute to disease severity. The results generated provide a robust research agenda, yielding critical information that elucidate molecular mechanisms, such as TRAIL up-regulation, that may contribute to the virulence and pathogenesis in human H5N1 disease.HKU 3 Minute Thesis Award, 2rd Runner-up (2011)
published_or_final_version
Pathology
Master
Master of Philosophy
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Neves, Elis Renata Filus. „Análise da sazonalidade e impacto dos vírus respiratórios em pacientes pediátricos internados em hospital de referência no Paraná“. Universidade Tecnológica Federal do Paraná, 2017. http://repositorio.utfpr.edu.br/jspui/handle/1/2728.
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As infecções respiratórias agudas são uma importante causa de morbidade e mortalidade infantil em todo o mundo. Algumas dessas infecções podem resultar em Síndrome Respiratória Aguda Grave (SRAG). Os vírus respiratórios são os principais responsáveis por esta doença. O monitoramento e a vigilância das SRAG e dos vírus respiratórios são importantes para a gestão em saúde minimizando o impacto destas infecções respiratórias. O presente estudo buscou analisar a sazonalidade e impacto clínico das infecções causadas por vírus respiratórios em crianças internadas em hospital pediátrico do Paraná. Foram incluídos no estudo 229 pacientes de 0 até 15 anos de idade, de janeiro de 2012 a dezembro de 2015, com diagnóstico clínico de SRAG e amostra respiratória coletada e enviada ao Laboratório Central do Estado do Paraná para diagnóstico do agente etiológico. A busca dos casos de SRAG foi realizada utilizando o prontuário eletrônico GSUS (Gestão da Assistência de Saúde do SUS), arquivos do setor de fisioterapia e informações do Núcleo de Controle de Infecções hospitalares do hospital do estudo. Dos pacientes incluídos na pesquisa, foi preenchido um formulário de coleta de dados e posteriormente estes foram analisados de acordo com os objetivos da pesquisa. As análises estatísticas foram efetuadas com o pacote estatístico GRAPHPAD PRISM e foi considerado um nível de significância de 5%. A maioria dos pacientes da amostra pertencia à faixa etária de 0 a 6 meses de idade, não houve sexo predominante. No presente estudo as amostras positivas para pelo menos um agente etiológico contabilizaram 76,41%, e o vírus mais prevalente foi o Vírus Sincicial respiratório (VSR). Quanto à sazonalidade da detecção viral, houve predominância no final de outono e início do inverno, mais acentuada para o VSR. Quando analisada as três temperaturas ambientais da região, a incidência de SRAG foi significativamente maior no quartil descendente da temperatura média para mínima. Não foi observada diferença significativa entre os grupos etiológicos pesquisados com relação ao tempo desde o início dos sintomas até a internação. Houve predominância de internamentos em Unidade de Terapia Intensiva. O tempo de internamento foi significativamente maior naqueles pacientes com doença de base e não alterou conforme os agentes etiológicos identificados ou presença de codetecção. Os pacientes que apresentaram padrão misto na radiografia de tórax tiveram um tempo de internamento significativamente maior do que aqueles que apresentaram o padrão infiltrado intersticial. O tempo total foi significativamente menor no grupo Metapneumovírus em relação aos grupos Bordetella pertussis, Influenza, Rinovírus e grupo dos pacientes sem agentes infecciosos detectados. O tempo de ventilação mecânica não apresentou diferenças significativas entre os grupos etiológicos nem com relação à presença ou não de codetecção. A maior parte dos pacientes recebeu alta hospitalar, mas ocorreram três óbitos devido a SRAG, todos em pacientes com alguma doença de base ou condições de risco.Acute respiratory infections are the most important cause of children morbidity and mortality worldwide. Some of these infections can result in Severe Acute Respiratory Syndrome (SARS). Respiratory viruses are primarily responsible for SARS. The monitoring and surveillance of SARS and respiratory viruses are important for health management, minimizing the impact of these respiratory infections. The present study was about the seasonality and clinical impact of respiratory viruses in children admitted to a pediatric reference hospital. The study included 229 children from 0 to 15 years old, from January 2012 to December 2015, with clinical diagnosis of SARS and respiratory sample collected and sent to the Central Laboratory of the State of Paraná for etiological agent analysis. The search for SARS cases was performed using the GSUS (Health Care Management of SUS) electronic filesystem, records of the center of physiotherapy and information of the Hospital Infection Control Center of the studied hospital. Of the patients included in the research, data collection forms were filled out and later analyzed according to the research objectives. Statistical analyzis were performed with the statistical package GRAPHPAD PRISM and a significance level of 5% was considered. The majority of patients in the sample belonged to the age group 0-6 months of age, and there was no predominant sex. Regarding the risk factors for viral infection, the presence of comorbidity or underlying disease was the most prevalent factor. In the present study, the positive samples for at least one etiological agent accounted for 76.41%, and the most prevalent virus was Respiratory Syncytial Virus (RSV). As for the seasonality of viral detection, there was a predominance in the late fall and early winter, which was more pronounced for RSV. When the environmental temperatures of the region were analyzed, the incidence of SARS was significantly higher in the descending quartile of the average minimum temperature. No significant difference was observed between the studied etiological groups in relation to the time from the beginning of the symptoms until the hospitalization. There was a predominance of hospitalizations in the Intensive Care Unit. The hospitalization time was significantly higher in patients with underlying disease or comorbidities and did not change according to the identified etiological agents or the presence of codetection. Patients who presented a mixed pattern on chest radiography had a significantly longer hospitalization time than those who had the interstitial infiltrate pattern. The total time was significantly lower in the Metapneumovirus group than in the Bordetella pertussis, Influenza, Rhinovirus and group of patients without detected infectious agents. Most patients were discharged from hospital, but there were three deaths due to SARS, all in patients with some underlying disease or risk conditions.
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Chung, Siu-fung. „An epidemiological study on the living environment, passive smoking and respiratory health of a cohort of children aged 3-6 years in Hong Kong /“. Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B17506360.
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Brickles, Vernon. „An assessment of the adherence to guidelines for the management of asthma exacerbations in selected primary healthcare facilities in the Western Cape“. Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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Asthma is described as a chronic inflammatory disorder of the airways. Recurrent episodes of acute attacks or exacerbation may occur in susceptible individuals. Asthma could be a controllable disorder and most people with asthma should be able to lead a n
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Chung, Siu-fung, und 鍾少鳳. „An epidemiological study on the living environment, passive smoking and respiratory health of a cohort of children aged 3-6 years in HongKong“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1995. http://hub.hku.hk/bib/B29967843.
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31
Smith, Samuel. „Instillation of Normal Saline During Endotracheal Suctioning: A Synthesis of Extant Research“. Honors in the Major Thesis, University of Central Florida, 2000. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/405.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucfBachelors
Health and Public Affairs
Nursing
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Svantesson, Cecilia. „Respiratory mechanics during mechanical ventilation in health and in disease“. Lund : Dept. of Clinical Psychology, Lund University, 1997. http://catalog.hathitrust.org/api/volumes/oclc/38987113.html.
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Powell, Tom. „Work of breathing in exercise and disease“. Thesis, University of South Wales, 2010. https://pure.southwales.ac.uk/en/studentthesis/work-of-breathing-in-exercise-and-disease(51104f52-5c03-4a4a-8c0a-f951fdf6388e).html.
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This thesis is focussed on developing new methods and outcomes to assess respiratory function that require little or no volitional effort on behalf of the participants being tested. Specifically to attempt to detach the behaviour of the patient from the accuracy of the test of respiratory function, resulting in techniques that are simpler and easier to administer and undertake for both assessor and participant. It aims to develop methods that reduce the involvement of the participant during assessment of respiratory function. The human body’s way of controlling respiration has evolved into a sophisticated system that optimises breathing pattern to maintain the most efficient homeostatic action of the respiratory system. Eliciting and assessing this automatic response is the key to removing the action of participation from respiratory functiontesting. The focus must therefore be on developing non-invasive, sub-maximal techniques that allow participants to enter into a steady state of respiration and how this can be assessed. Two techniques were investigated; Respiratory Endurance (as the inspiratory work of breathing) and Tidal Breathing Flow Profile, and these were successfully applied in 99 adult participants (68 healthy controls and 31 COPD patients) and 75 children (48 clinical group and 27 healthy controls) who completed 467 respiratory endurance trials whilst seated and exercising, and 249 relaxed tidal breathing trials. The difficulties with lung function assessment are well established and have been described in this thesis. Much recent emphasis has been put on developing existing devices and protocols rather than developing new techniques and approaching these difficulties from alternative viewpoints. This thesis has described the development of innovative techniques to assess the function of the respiratory systems that aim to overcome the issues associated with maximal testing. It was shown that these techniques are easy to undertake for a range of participants, simple to analyse and are able to reliably differentiate between health and disease, suggesting that they could become a useful adjunct to existing methods of respiratory assessment.
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Yu, Peng. „Air pollution and respiratory disease incidence of Guangzhou a study of spatial interpolation methods using GIS, 2003-2004 /“. Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41633799.
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Kendall, Lonnie Vern. „The host immune response to the cilia-associated respiratory (CAR) bacillus and immunopathogensis [sic] of disease“. free to MU campus, to others for purchase, 2000. http://wwwlib.umi.com/cr/mo/fullcit?p9974646.
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Kendall, Lonnie Vern. „The host immune response to the cilia-associated respiratory (CAR) bacillus and immunopathogensis [i.e. immunopathogenesis] of disease /“. free to MU campus, to others for purchase, 2000. http://wwwlib.umi.com/cr/mo/fullcit?p9974646.
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Ravipati, Hari Prasad. „The modifiable risk factors for snoring and the implications for chronic disease“. restricted, 2009. http://etd.gsu.edu/theses/available/etd-07232009-082122/.
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Thesis (M.P.H.)--Georgia State University, 2009.Title from file title page. Michael P Eriksen, committee chair; Sheryl Strasser, committee member. Description based on contents viewed Feb. 22, 2010. Includes bibliographical references (p. 55-65).
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Rajabimoghaddam, Bidokhti Mehdi. „A study of bovine coronavirus (BCV) and bovine respiratory syncytial virus (BRSV) infections in dairy herds in Sweden /“. Uppsala : Department of Clinical Sciences, Swedish University of Agricultural Sciences, 2008. http://epsilon.slu.se/10718972.pdf.
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Pavelescu, Adriana. „Echocardiography for the noninvasive study of the pulmonary circulation: applications to the study of right ventricular effects of targeted therapies of pulmonary hypertension, limiting factors to exercise capacity, and detection of early pulmonary vascular disease in healthy subjects“. Doctoral thesis, Universite Libre de Bruxelles, 2012. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209616.
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Ce travail a été consacré à l’étude non invasive de la circulation pulmonaire normale par mise en œuvre de l’échocardiographie Doppler. En intégrant les mesures obtenues dans une approche physiopathologique, et en exploitant les nouvelles possibilités d’échocardiographes portables, techniquement performants, nous avons analysé les effets d’un inhibiteur de la phosphodiestérase-5 et d’une prostacycline, pour tenter d’en identifier d’éventuels effets introtropes intrinsèques, nous avons exploré le concept de réserve vasculaire pulmonaire comme facteur limitant de l’aptitude aérobie et indice potentiel d’une atteinte vasculaire pulmonaire précoce, et obtenu des résultats préliminaires permettant d’identifier une hypertension artérielle pulmonaire (HTAP) latente. Nos principaux résultats peuvent être résumés comme suit :
1. Chez le sujet sain, en normoxie ou dans un modèle expérimental d’HTAP induite par l’inhalation d’un mélange gazeux hypoxique, le sildenafil per os ou l’epoprostenol par voie intraveineuse, à des doses utilisées en clinique pour le traitement de l’HTAP, améliorent les indices de la fonction ventriculaire droite en proportion de leurs effets vasodilatatoires pulmonaires, sans effets inotropes intrinsèques détectables.
2. La consommation d’oxygène maximale du sujet sain augmente en raison directe de son volume capillaire pulmonaire (calculé à partir de sa capacité de diffusion pour l’oxyde nitrique et le monoxyde de carbone) et en raison inverse de sa résistance vasculaire pulmonaire, non seulement en altitude, mais aussi au niveau de la mer. Ce résultat suggère qu’une plus grande réserve vasculaire pulmonaire est propice aux efforts aérobiques intenses, probablement par moindre postcharge ventriculaire droite.
3. Des mesures réalisées chez un petit nombre de sujets suggèrent que la distensibilité vasculaire pulmonaire, calculée à partir d’une relation débit-pression vasculaire pulmonaire, est typiquement réduite chez des porteurs asymptomatiques de la mutation BMPR2, qui est actuellement le facteur de risque le plus élevé connu de l’HTAP. La mutation BMPR2 pourrait aussi être associée à une réactivité vasculaire pulmonaire accrue à l’hypoxie.
Nos résultats suggèrent indirectement que l’échocardiographie Doppler, de repos ou de stress, pourrait être davantage développée dans la mise au point de patients à risque d’HTAP./
Novel advances in echocardiography offer the opportunity to reliably characterize pulmonary circulation in terms of pressure-flow relationship, and to better understand the coupling of right ventricular (RV) function with normal and abnormal pulmonary hemodynamics. Moreover, when combined with the measurement of pulmonary capillary blood volume, this renewed methodological approach may help to understand the concept of pulmonary vascular reserve as a limiting factor of exercise capacity and potential sensitive marker of early vascular disease.
In the present work we used a model of hypoxic pulmonary vasoconstriction to analyse the effects of two targeted therapies of pulmonary arterial hypertension (PAH) on the RV function. We showed that the beneficial effects of these drugs are mainly driven by a decrease in RV afterload and not an enhanced myocardial inotropic state. Whether this is transposable to abnormal RV-arterial coupling in PAH patients remains to be investigated.
Echocardiography may be useful to explore the pulmonary vascular reserve as an important limiting factor of exercise capacity. We showed that a higher pulmonary vascular reserve, defined by a decreased PVR and increased lung diffusing capacity, allows for an improved aerobic exercise capacity (as assessed by a higher peak oxygen consumption), at a lower ventilatory cost, at sea level and at high altitude.
Stress echocardiography may detect an abnormal pulmonary vasoreactivity. We showed that asymptomatic relatives of patients suffering from idiopathic pulmonary arterial hypertension, and who carry a bone morphogenetic protein receptor type 2 mutation (BMPR2) present with a decreased pulmonary vascular distensibility and an enhanced pulmonary vasoreactivity to hypoxia, which are identifiable by echocardiography examination. However, the predictive value of these findings is not known.
Thus echocardiography may represent, in experienced and dedicated hands, a noninvasive, safe, widely available, applicable at the bed-side as well as in extreme environment (e.g. high altitudes), less expensive alternative for the evaluation of the pulmonary circulation, either by the interrogation of pressure-flow relationship (stress echocardiography), by the investigation of the right ventricle global and regional function in relation to its afterload (standard and Tissue Doppler Imaging), or by a combined approach with the measurement of lung diffusing capacity (DLNO / DLCO) to assess the pulmonary vascular reserve.
The present data are encouraging for further development and implementation of echocardiography for the detection, but also the diagnosis and follow-up of patients with pulmonary hypertension.
Doctorat en Sciences médicales
info:eu-repo/semantics/nonPublished
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Abrar, Mahdi. „Respiratory pathogenesis of Pasteurella Multocida in turkeys“. Thesis, 1991. http://hdl.handle.net/1957/37228.
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Pasteurella multocida causes diseases in many animal
species including fowl cholera, a septicemic disease of
poultry and other birds. Pathogenesis of the disease has
been studied by many investigators by the systemic
administration of the organism in poultry. However, only a
few studies have been done as to the respiratory
pathogenesis of the organism. The objective of the study
was to investigate the fate of P. multocida after the
intratracheal administration in turkeys
The fate of four strains of Pasteurella multocida was
studied after their intratracheal inoculation in young adult
turkeys. Viable bacterial counts were made in respiratory
tissues as well as in the liver, spleen and blood at 6 and 9
hrs after the inoculation of approximately 10⁹ viable
organisms of each strain. A virulent, encapsulated strain,
P-1059, invaded systemically by 6 hrs postinoculation (PI)
and multiplied vigorously in all tissues and organs
examined. A blue colony mutant of P-1059, T-325, which does
not possess a thick layer of capsule, as well as CU vaccine
strain, invaded the parenchymal organs, but did not show
significant increase in viable counts at 9 hrs PI compared
with at 6 hrs PI. Another vaccine strain, M-9, also invaded
blood and internal organs by 6 hrs PI, however, its viable
counts showed no significant change between 6 and 9 hrs PI,
or in some tissues significant decrease at 9 hrs PI. The
results indicate that all the four strains possess high
capacity to invade respiratory tissues with varying capacity
to persist in host tissues.
The lesions caused by two strains of Pasteurella
multocida (P-1059 and M-9) were observed after their
intratracheal inoculation in young adult turkeys. The
lesions were observed in the respiratory organs at 0, 0.25,
0.5, 1, 2, 3, and 6 hrs after inoculation of approximately
10⁹ viable organisms of each strain. Both virulent strain,
P-1059 and non-virulent vaccine strain, M-9, have capacity
to invade and multiply in the tissues examined.
Macroscopicly, the lesions in the lung and in the airsac
were found as early as 1 hr PI, including the infected lung
was foamy and the airsac became cloudy. They became more
severe by 2 to 6 hrs PI. Microscopicly, hecerophiles were
present, occasionally, in the lung, trachea and airsac by 0
to 1 hr after inoculation. Then they became more severe by
2 to 6 hrs PI. By 6 hrs PI, there were diffuse
heterophiles infiltration in the trachea, lung, anc airsac.
The lung vascular was edema. The trachea ciliate and mucous
gland was cystic or hyperplasia, and the airsac shewed
increased in thickness and cloudiness. These results of
study indicate that the lesion caused by P-1059 and vaccine
strain, M-9, were not significantly different.Graduation date: 1992
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Reynolds, Paul N. (Paul Nigel). „The role of tachykinins in airway inflammation and bronchial hyper-responsiveness“. 1999. http://web4.library.adelaide.edu.au/theses/09PH/09phr464.pdf.
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Bibliography: leaves 217-244. Tachykinins are implicated in the mediation of airway inflammatory responses and may have roles in airway remodeling and healing. The actions of tachykinins are mediated by specific receptors, designated NK1, NK2 and NK3. Tachykinin degredation, an important mechanism for limiting the effects of these peptides, is principally mediated by neutral endopeptidase (NEP). This thesis investigates the role of tachykinins, in vivo, in an ovine model and in human airway epithelium. Results show that the nett effect of tachykinins in the airway will depend on the relative balance between the expression of receptors, tachykinins and NEP. Assessment of these molecules in the airway epithelium from subjects with normal lungs or chronic bronchitis showed that preprotachykinin-A gene expression was relatively higher in the disease group whereas NEP and NK1 receptor levels were unchanged. These studies provide new insights into the role of tachykinins in airways disease.
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Reynolds, Paul Nigel. „The role of tachykinins in airway inflammation and bronchial hyper-responsiveness / Paul N. Reynolds“. Thesis, 1999. http://hdl.handle.net/2440/19548.
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Bibliography: leaves 217-244.x, 246 leaves : ill. (chiefly col.) ; 30 cm.
Tachykinins are implicated in the mediation of airway inflammatory responses and may have roles in airway remodeling and healing. The actions of tachykinins are mediated by specific receptors, designated NK1, NK2 and NK3. Tachykinin degredation, an important mechanism for limiting the effects of these peptides, is principally mediated by neutral endopeptidase (NEP). This thesis investigates the role of tachykinins, in vivo, in an ovine model and in human airway epithelium. Results show that the nett effect of tachykinins in the airway will depend on the relative balance between the expression of receptors, tachykinins and NEP. Assessment of these molecules in the airway epithelium from subjects with normal lungs or chronic bronchitis showed that preprotachykinin-A gene expression was relatively higher in the disease group whereas NEP and NK1 receptor levels were unchanged. These studies provide new insights into the role of tachykinins in airways disease.
Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 1999
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Pinnock, Carole B. (Carole Bolton). „Vitamin A status and susceptibility to respiratory illness“. 1987. http://web4.library.adelaide.edu.au/theses/09PH/09php656.pdf.
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Corr, Peter David. „Life threatening haemoptysis : a clinical and radiological study“. Thesis, 2003. http://hdl.handle.net/10413/7652.
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The investigation and management of patients with life threatening haemoptysis is a common clinical problem in South African Hospitals.
Establishing the aetiology and origin of the haemorrhage and treating these patients is both difficult and expensive in terms of human and financial resources. The purpose of this study was to identify common local aetiologies for severe haemoptysis, review the investigation and treatment of these patients at Wentworth Hospital, Durban and to formulate a plan of management. Retrospective and prospective studies of consecutive patients treated at Wentworth Hospital were performed. In the prospective study a new embolic material gelatin linked acryl microspheres (embospheres) was used for bronchial artery embolization (BAE). The study demonstrated a change in the spectrum of aetiologies of haemoptysis, from bronchiectasis following tuberculosis to destructive pneumonias. The chest radiograph was always the initial imaging investigation but was found to be inaccurate in detecting the origin of the bleeding. High resolution computed tomography of the lungs (HRCT) was the single best investigation to detect the cause and origin of the haemoptysis. HRCT detected focal bronchiectasis and intracavitatory aspergillomas that were undetected on the chest radiograph. Pleural thickening detected on CT was a good indicator of the presence of transpleural collaterals. The major limitation with HRCT was that it could not be performed if the patient was too dyspnoeic to cooperate during the scan. The role of bronchoscopy appears limited in patients with severe haemoptysis to those patients who are potential surgical candidates. I found that bronchoscopy was not accurate in detecting the source of bleeding in the few patients in which it was performed. Bronchial arteriography remains the gold standard in the detecting the source of haemorrhage. Bleeding sites were detected on angiography in the presence of focal hypervascularity, neovascularity and the presence of broncho-pulmonary shunts. Bronchial arteries were hypertrophied in bronchiectasis but were normal in size in some patients who had acute pneumonias. Bronchial artery embolization was the treatment of choice for severe haemoptysis in the patients studied. The use of gelatin cross linked micro spheres has significantly improved the initial success rate following the procedure with less complications compared to the use of polyvinyl alcohol particles (PVA). It is important to identify systemic transpleural collaterals at arteriography and to embolize them to reduce recurrent haemoptysis. Patients with aspergillomas responded well to embolization. Recurrent haemoptysis remains the major limitation of BAE but is reduced with the use of micro spheres as embolic agents and thorough embolization of systemic collaterals on the affected side. Surgical resection was an option for a limited number of patients with focal disease in one lung and good respiratory reserve. The major limitation of the study was the absence of long term follow up to detect those patients with late recurrent haemoptysis.Thesis (D. Med.)-University of Natal, Durban, 2003.
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Eckert, Danny Joel. „The effects of hypoxia on respiratory sensation and reflexes in healthy subjects : implications for sleep and respiratory disease“. 2006. http://hdl.handle.net/2440/38836.
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Hypoxia is a common feature of many respiratory disorders including acute severe asthma, chronic obstructive pulmonary disease and pneumonia. Hypoxia also occurs during sleep - disordered breathing in conditions such as sleep hypoventilation syndrome and sleep apnea. In most respiratory diseases hypoxia is coupled with increased respiratory load. Compensatory protective mechanisms are activated to oppose these impediments to respiration. However, hypoxia is associated with impaired neurocognitive function and recent studies have demonstrated that hypoxia suppresses respiratory load perception in healthy individuals and asthma patients. These recent findings raise the possibility that a variety of protective physiological reflex responses to increased respiratory load may be impaired during periods of hypoxia. The effects of hypoxia on several of these protective responses and possible mechanisms of respiratory sensory depression by hypoxia are explored in the experiments outlined in this thesis. In the first study, the respiratory related evoked potential ( RREP ) was used to investigate the mechanisms underlying hypoxia - induced suppression of respiratory load sensation in healthy individuals. As a positive control the effects of hypoxia on respiratory load perception to inspiratory resistive loads were also measured. The amplitude of the first and second positive peaks ( P1 and P2 ) of the RREP were significantly reduced during hypoxia. P1 is thought to reflect the arrival of the ascending respiratory signals to the somatosensory area of the cortex. The perceived magnitude of externally applied inspiratory resistive loads was also reduced during hypoxia. These data provide further support that hypoxia suppresses respiratory load perception and suggest that this is mediated, at least in part, by suppression of respiratory afferent information prior to its arrival at the cortex. In the second study, the effects of acute sustained hypoxia on the cough reflex threshold and cough tachyphylaxis to inhaled capsaicin were explored in healthy individuals. Acute sustained hypoxia suppressed cough reflex sensitivity to inhaled capsaicin. This finding raises the possibility that the cough reflex, important for protecting the lungs from inhalation or aspiration of potentially injurious substances and for clearing excess secretions, may be impaired during acute exacerbations of hypoxic - respiratory disease. In the third study, reflex responses of the genioglossus and scalene muscles to brief pulses of negative airway pressure were compared between hypoxia and normoxia during wake and sleep in healthy males in the supine position. Cortical RREPs to the same stimuli were also examined under these conditions. The genioglossus is the largest upper airway ( UA ) dilator muscle and can be reflexively augmented in response to negative UA pressure. A diminished response of this muscle during sleep has been postulated to be a contributing mechanism to obstructive sleep apnea ( OSA ) in individuals with an anatomically narrow UA. Cortical activation ( i.e. arousal ) to sudden airway narrowing in OSA is an important protective response to help restore ventilation during an obstructive event. In this study, genioglossus reflex responses to negative pressure pulse stimuli were maintained during mild overnight hypoxia. Conversely, reflex inhibition of the scalene muscle to the same stimuli was prolonged during hypoxia. In addition, a previously undescribed morphology of the genioglossus negative pressure reflex consisting of activation followed by suppression was observed with greater suppression during sleep than wake. The amplitude of the P2 component of the RREP was also significantly reduced during hypoxia. In summary, the potential mechanisms underlying hypoxia - induced suppression of respiratory load sensation and the effects of hypoxia on several protective respiratory responses have been investigated in healthy subjects. The potential implications of these findings for patients with hypoxic - respiratory disease are discussed.Thesis (Ph.D.)--School of Molecular and Biomedical Science, 2006.
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Edmunds, Brett. „Lower respiratory tract disorders and thoracic spine pain and dysfunction in subjects presenting to the Durban Institute of Technology Chiropractic Day Clinic : a retrospective clinical survey“. Thesis, 2003. http://hdl.handle.net/10321/361.
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Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2003. x, 101 leavesAnecdotal evidence and some developmental theory suggest that lower respiratory tract pathologies may be associated with thoracic spine pain and dysfunction. This hypothetical association may be better described either as respiratory conditions occurring as a result of musculoskeletal dysfunction of the thoracic spine, or as respiratory conditions causing thoracic musculoskeletal dysfunction. Optimal function of the lungs and the process of ventilation is dependant on the normal function of the thoracic spine and the rib cage. Disturbances of the musculoskeletal components of the thoracic spine may lead to increased respiratory efforts, decreased lung function and in turn affect bronchopulmonary function. Obstructive respiratory diseases such as asthma, bronchitis and emphysema place an increased demand on the musculoskeletal components involved in expiration, as air has to be forcefully expired. The purpose of this quantitative, non experimental, demographic retrospective clinical survey was to retrospectively describe lower respiratory tract disorders and thoracic spine pain and dysfunction in subjects presenting to the Durban Institute of Technology Chiropractic Day Clinic, in terms of the prevalence of lower respiratory tract disorders as well as any association between the presenting respiratory conditions and their vertebral distribution in the thoracic spine.
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Graham, Neil M. H. (Neil Murray Hamilton). „Psychosocial factors in the epidemiology of acute respiratory infection“. 1987. http://web4.library.adelaide.edu.au/theses/09MD/09mdg741.pdf.
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Yuan, Jiayao. „Dynamic Modeling and System Identification of the Human Respiratory System“. Thesis, 2021. https://doi.org/10.7916/d8-t170-t155.
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The lungs are the primary organ of the respiratory system. Their main function is to provide freshly breathed oxygen (O²) to the blood capillaries, while taking carbon dioxide (CO²) from them and expelling it to the atmosphere. Lung conditions such as Acute Respiratory Distress Syndrome (ARDS), Idiopathic Pulmonary Fibrosis (IPF), Coronavirus Disease (COVID-19), etc., cause impaired gas exchange that is life-threatening. In this dissertation, I developed 1) a physiology-based dynamic pulmonary system to study the lung normo- and patho-physiology, and 2) a model-based constrained optimization algorithm to do parameter estimation in order to non-invasively assess lung health.
The goals of this work are 1) to accomplish a respiratory personalized medicine example for clinical decision support, and 2) to further the understanding of respiratory physiology, via a mechanistic physiology-based model and system identification techniques. The mechanistic model presented in this thesis comprises six subsystems: 1) a lung mechanics module that computes airflow transport from the mouth and nose to the alveoli (gas exchange units), 2) a respiratory muscles and rib cage mechanics module that simulates the effect of the respiratory muscle contraction on the lungs and the rib cage, 3) a microvascular exchange system that describes fluid (water) and mass (albumin and globulin) transport between the pulmonary capillaries and the alveolar space, 4) an alveolar elasticity module that computes alveolar compliance as a function of the pulmonary surfactant concentration and the elastic properties of the lung tissue fiber, 5) a pulmonary blood circulation that describes blood transport from the heart to the pulmonary system, and 6) a gas exchange system that describes O² and CO² transport between blood in the pulmonary capillaries and gas in the alveoli. Each subsystem was developed based on the latest knowledge of lung physiology and was validated using patient data when available or published and validated physiology-based models. To our knowledge, the combined six-module model would be the most rigorous and expansive lung dynamic model in the literature. This dynamic respiratory system can be used to describe human breathing under healthy and diseased conditions. The model can readily be used to test different what-if scenarios to find the optimal therapy for the patients.
Further, I tailor the proposed lung model and adopt system identification techniques for noninvasive assessment of the lung mechanical properties (resistance and compliance) and the patient breathing effort. Pulmonary syndromes or diseases, such as ARDS and COPD (Chronic Obstructive Pulmonary Disease) evoke alterations in lung resistance and compliance. These two parameters reflect, by and large, the state of health and functionality of the respiratory system. Hence tracking these two parameters can lead to better disease diagnosis and easier monitoring of the respiratory disease progression. For spontaneously breathing patients on ventilatory support, the estimation of the lung parameters is challenging due to the added patient’s breathing effort. This dissertation presents a model-based nonlinear constrained optimization algorithm to estimate, breath-by-breath, the lung resistance, the lung compliance, as well as the patient breathing effort due to the respiratory muscle activity, using readily available non-invasive measurements (airway opening pressure and airflow).
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De, Waard Anton Hans. „Respiratory tract symptoms in multi-day trail runners - a focus on allergy“. Thesis, 2012. http://hdl.handle.net/10413/6290.
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Introduction: Respiratory tract symptoms (RTS), common in athletes during heavy training and
after events, result in impaired readiness for events and race times. Since the 1980’s exercise
immunologists have investigated the aetiological factors surrounding the development of
exercise induced RTS in order to develop effective preventative strategies. A number of theories
have been put forward and explored, such as increased susceptibility to infection, ‘run-away’
inflammatory response and reactivation of prior viral infection. It has been suggested that the
mechanisms producing exercise induced inflammation could potentiate allergic responses in
sensitized individuals and recently allergic response has been proposed as a potential contributor
to exercise induced RTS. Certainly allergic reactions can produce a range of respiratory
symptoms; however the relationship between allergic sensitization, allergic reaction and the
incidence of post-exercise RTS has not been well defined.
Objectives: The primary objective of this study was to document the incidence of RTS for two
weeks before and two weeks after a three-day trail run and relate these to the general systemic
and salivary immunological profile as well as atopic status of the participants. The secondary
objective was to validate the use of the Phadiatop® assay as a predictor of allergy-associated
post-race RTS in trail runners.
Study Design and Methods: The study formed part of a larger, descriptive field study
examining the physiological responses of trail runners during the Three Cranes Challenge, a
multi-day 95 km event divided into three stages, in Karkloof, KwaZulu-Natal. Outcome
measures examined included self- reported RTS over a 31 day period (pre, during and post race),
as well as pre-race Phadiatop® status, salivary IgA (sIgA) concentrations and changes in
concentrations of serum IgE (sIgE), cortisol, high sensitivity C-Reactive Protein (hs-CRP) and
differential leukocyte counts. The haematological and salivary parameters were obtained at 8
time points before, during and after the event.
A convenience sample of 22 individuals was used and two separate analyses were conducted on
the data. The inclusion criteria of the first analysis were met by 14 participants. In this analysis,
the incidence of RTS was related to each participant’s general immunological profile. Sixteen of
the subjects met the inclusion criteria for the second analysis, in which their Phadiatop® status
was related to their sIgE and blood eosinophil and basophil concentrations in order to establish
the validity of the Phadiatop® assay in predicting the development of allergy–associated postexercise
RTS in trail runners.
Results: In the first analysis, 78.6 % (n=11) of subjects met the criteria for positive diagnosis of
upper respiratory symptoms (URS) during the two week post-race period. In four subjects (36.4
%), URS appeared to be of inflammatory origin, but these were not linked to systemic markers of
an allergic response. Of the URS positive subjects, six (54.5 %) presented with markers of
infection, three (27.3 %) with markers of a de novo infection and three (27.3%) with a profile
suggestive of reactivation of previous infection. Of those presenting with markers of infection
66.7 % (n=4) had concomitantly elevated levels of IgE suggestive of allergic response. There
was, however, no evidence of isolated allergic reaction independent of other causes amongst the
symptomatic subjects.
In the second analysis, 75% (n=12) of runners presented with post-race RTS and seven of these
were Phadiatop® positive. In four of the Phadiatop® positive RTS subjects, symptoms appeared
to be of allergic origin. Although total IgE concentrations were significantly higher (p< 0.01) in
Phadiatop® positive group, there was no significant difference between the eosinophil and
basophil concentrations or post-race RTS of the positive and negative groups (p>0.05). Of the
four subjects who did not develop RTS, three were Phadiatop® positive.
Conclusion: Respiratory tract symptoms in trail runners have a multi-factorial aetiology. A link
between concurrent markers of an allergic response and infection is common in symptomatic
trail runners. The Phadiatop® assay does not accurately predict the incidence of allergic postexercise
RTS in trail runners.Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Westville, 2012.
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Sharkhuu, Tuya. „Mechanisms predisposing the development of allergic airways disease“. Phd thesis, 2005. http://hdl.handle.net/1885/149914.
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